| NPI | 1467462176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH011909) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 011909) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2019-12-09 |