| NPI | 1255880365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH015610) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS 14255) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2016-09-30 |