| NPI | 1134411903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DC PH100000828) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202210272) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-05-11 |