| NPI | 1487772265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 6219) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH013474) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-08 |