| NPI | 1922586130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH029556) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH059556) |
| Enumeration Date | 2018-07-31 |
| Last Update Date | 2021-01-18 |