| NPI | 1962175067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 13253763-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI PH-4676) |
| 183500000X Pharmacist (Licence: NV 23029) | |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2023-08-07 |