| NPI | 1063813558 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH032484) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS51900) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2021-09-13 |