| NPI | 1598167108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 21217) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC Ph100001180) |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |