| NPI | 1588653471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS 31128) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH 018310) |
| 183500000X Pharmacist (Licence: FL PU 4888) | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2007-07-08 |