| NPI | 1194062315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS46232) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH021261) |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2013-01-08 |