| NPI | 1184636706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS36315) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: FL PU5966) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2021-01-22 |