| NPI | 1851546113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH020095) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202004657) |
| Enumeration Date | 2008-11-28 |
| Last Update Date | 2008-11-28 |