| NPI | 1053439810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH019049) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 019049) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2022-12-23 |