| NPI | 1821321928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 19679) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100000682) |
| 183500000X Pharmacist (Licence: TX 51318) | |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2014-10-20 |