| NPI | 1922562396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI PH-4305) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA PH60753124) |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2019-01-30 |