| NPI | 1770945420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 23944) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202214256) |
| 183500000X Pharmacist (Licence: DC PH100002134) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2022-12-16 |