| NPI | 1073853933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH028237) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS34598) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2017-01-21 |