| NPI | 1912308131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DC PH100001767) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 22580) |
| Enumeration Date | 2014-09-07 |
| Last Update Date | 2014-09-22 |