| NPI | 1841259710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH022581) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC011947) |
| 101YP2500X Counselor, Professional (Licence: TN 4163) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2021-09-21 |