| NPI | 1669786679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 19334) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100000726) |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2010-08-02 |