| NPI | 1205269248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH27395) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 14175) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2021-09-21 |