| NPI | 1841544129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: GA RPH023312) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: FL PS41232) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2012-11-07 |