| NPI | 1376927483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH028599) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 36164) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |