| NPI | 1497004873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 14405) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS21353) |
| 183500000X Pharmacist (Licence: SC 9987) | |
| 183500000X Pharmacist (Licence: NC 14824) | |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-08-31 |