| NPI | 1447528575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH029665) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: GA 9103405) |
| Enumeration Date | 2011-12-04 |
| Last Update Date | 2026-04-16 |