| NPI | 1326573742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835N0905X Pharmacist, Nuclear (Licence: GA 16456) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS26170) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |