| NPI | 1134443344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH025889) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 33291) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2017-01-24 |