| NPI | 1225420094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 21992) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100001884) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2015-03-03 |