| NPI | 1740483403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS35127) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: FL PU6125) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2007-07-08 |