| NPI | 1013904408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH033797) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AR 6934) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2022-12-22 |