| NPI | 1861097099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: GA 014305) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: TN 0000042850) |
| 1835G0303X Pharmacist, Geriatric (Licence: SC 37950) | |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-04 |