| NPI | 1922545128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 36867) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 15981) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2021-08-16 |