| NPI | 1538356910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 017598) |
| Additional Taxonomies | 1835N0905X Pharmacist Nuclear (Licence: GA 017598) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2007-09-28 |