| NPI | 1528382090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 10955) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202010556) |
| 183500000X Pharmacist (Licence: DC PH2351) | |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2010-03-26 |