| NPI | 1588002224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 15375) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PHA3223) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |