| NPI | 1356764989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 64232) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: IN AU) |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-04-01 |