| NPI | 1255679585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 13868) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH3254) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2013-01-22 |