| NPI | 1215414651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH025264) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TN 33284) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |