| NPI | 1366740565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC PH 4362) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH011309) |
| Enumeration Date | 2011-03-11 |
| Last Update Date | 2011-03-11 |