| NPI | 1710135561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 14344) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PHA23315;) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2008-09-05 |