| NPI | 1205147436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH013039) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 11583) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2010-06-22 |