| NPI | 1013220730 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835C0207X Pharmacist, Compounded Sterile Preparations (Licence: AR PD14410) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 14707) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2023-04-11 |