| NPI | 1447374319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 17928) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC ph100000344) |
| Enumeration Date | 2007-03-18 |
| Last Update Date | 2008-11-06 |