| NPI | 1982184776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OR RPH-0017986) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 42081) |
| 183500000X Pharmacist (Licence: WV RP0010738) | |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2022-11-25 |