| NPI | 1639412737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DC PH100000920) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20011) |
| 183500000X Pharmacist (Licence: NJ 28RI03386100) | |
| 183500000X Pharmacist (Licence: VA 0202210362) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2013-03-27 |