| NPI | 1518287655 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 1783)  | 
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NH 1783)  | 
| Enumeration Date | 2010-06-10 | 
| Last Update Date | 2010-06-10 |