| NPI | 1811142136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202005447) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH2224) |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2008-12-01 |