| NPI | 1306144266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH026950) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 12649) |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2014-08-29 |