| NPI | 1083828644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 15905) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202208964) |
| 183500000X Pharmacist (Licence: DC PH100000754) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2021-08-07 |