| NPI | 1063936987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH029970) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 27176) |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2022-07-21 |