| NPI | 1841573839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH024956) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA 024956) |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2017-12-07 |