| NPI | 1003064866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 13936) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PHA3147) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-09-05 |