| NPI | 1467973388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS23507) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH015396) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2017-06-30 |