| NPI | 1023523875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DC PH100003571) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202217618) |
| 183500000X Pharmacist (Licence: TX 61933) | |
| 183500000X Pharmacist (Licence: MD 29328) | |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2023-12-12 |