| NPI | 1831488980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS34331) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: FL PS34331) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |