| NPI | 1568744134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA rph022398) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps34210) |
| 183500000X Pharmacist (Licence: CO 15764) | |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |