| NPI | 1639513633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000006830) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 19052) |
| 183500000X Pharmacist (Licence: DC PH100000768) | |
| Enumeration Date | 2013-04-20 |
| Last Update Date | 2013-04-20 |