| NPI | 1992027825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P5829) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0010704) |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2020-03-30 |