| NPI | 1902202500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 0000034758) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH028175) |
| 183500000X Pharmacist (Licence: DC PH100001141) | |
| Enumeration Date | 2014-11-08 |
| Last Update Date | 2014-11-08 |