| NPI | 1013634260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 24302) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100002890) |
| 183500000X Pharmacist (Licence: VA 0202216460) | |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2022-10-27 |