| NPI | 1689183956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 24960) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100002885) |
| 183500000X Pharmacist (Licence: VA 0202215321) | |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |