| NPI | 1669873899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202211424) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20691) |
| 183500000X Pharmacist (Licence: DC PH100001426) | |
| 183500000X Pharmacist (Licence: CA 68455) | |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-09-08 |