| NPI | 1972778256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 11449) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH018406) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-04-28 |