| NPI | 1215928718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: FL PU5959) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS34023) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2009-01-02 |