| NPI | 1972937431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH025538) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 21158) |
| Enumeration Date | 2013-09-02 |
| Last Update Date | 2020-12-21 |