| NPI | 1427332550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH022394) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 16540) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2022-12-23 |