| NPI | 1659619278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS36379) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH020716) |
| 183500000X Pharmacist (Licence: AL 16323) | |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |