| NPI | 1487049383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH029476) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL S10857) |
| 183500000X Pharmacist (Licence: GA PHI-016542) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2022-12-15 |