| NPI | 1023694122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 18987) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100003609) |
| 183500000X Pharmacist (Licence: VA 0202209478) | |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2021-03-20 |