| NPI | 1831461649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835N1003X Pharmacist Nutrition Support (Licence: FL PS46775) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS46775) |
| Enumeration Date | 2012-02-09 |
| Last Update Date | 2012-02-09 |