| NPI | 1952561904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: GA rph018955) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA rph018955) |
| 183500000X Pharmacist (Licence: FL ps31905) | |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2018-06-20 |