| NPI | 1205448743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS60698) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH030722) |
| 183500000X Pharmacist (Licence: SC 43104) | |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2022-01-07 |