| NPI | 1710315924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS50917) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH027549) |
| Enumeration Date | 2013-10-25 |
| Last Update Date | 2023-05-16 |