| NPI | 1144598707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH023024) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 043050) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2023-01-31 |