| NPI | 1265987093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH029262) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC PH.36636) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |