| NPI | 1215325667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 12198) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH024008) |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2020-05-21 |