| NPI | 1104240548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: FL PS53992) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS53992) |
| Enumeration Date | 2014-02-05 |
| Last Update Date | 2019-07-26 |