| NPI | 1528273562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: LA PST.018510) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 10843) |
| 183500000X Pharmacist (Licence: TX 40801) | |
| 1835G0303X Pharmacist, Geriatric (Licence: AZ 13431) | |
| Enumeration Date | 2007-05-12 |
| Last Update Date | 2012-09-25 |