| NPI | 1780962811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202207921) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18874) |
| 183500000X Pharmacist (Licence: DC ph100001076) | |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2013-10-14 |