| NPI | 1356778369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH027443) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 24939) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2015-07-15 |