| NPI | 1891147872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 11520) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA rph023144) |
| Enumeration Date | 2016-07-01 |
| Last Update Date | 2016-07-01 |