| NPI | 1356688295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH021758) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: GA 2784) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2017-04-06 |