| NPI | 1588030381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH029782) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 25019) |
| Enumeration Date | 2015-08-15 |
| Last Update Date | 2019-09-17 |