| NPI | 1720386394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH020970) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AL RPH14240) |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2011-03-07 |