| NPI | 1700465291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS64141) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH032926) |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2022-08-10 |