| NPI | 1972743755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202007452) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DC PH100000411) |
| 183500000X Pharmacist (Licence: NC 14610) | |
| 183500000X Pharmacist (Licence: MD 18090) | |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2009-03-06 |