| NPI | 1285176594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 24987) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100003006) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2019-02-25 |