| NPI | 1376851030 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 19631) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100000886) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-11-22 |