| NPI | 1336745579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DC PH100000995) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20615) |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2020-12-10 |