| NPI | 1508314394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DC PH100002635) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202215391) |
| 183500000X Pharmacist (Licence: MD 24380) | |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2019-01-05 |