| NPI | 1912376393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI PH-4546) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60572061) |
| Enumeration Date | 2015-09-16 |
| Last Update Date | 2020-12-09 |