| NPI | 1487095881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS41005) |
| Additional Taxonomies | 1835N1003X Pharmacist Nutrition Support (Licence: FL PU 6938) |
| Enumeration Date | 2013-07-13 |
| Last Update Date | 2013-07-13 |