| NPI | 1750677225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202209649) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100000840) |
| 183500000X Pharmacist (Licence: WV RP0007517) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-06-23 |