| NPI | 1982039608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 32337) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 14356) |
| 183500000X Pharmacist (Licence: GA RPH27515) | |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2024-11-03 |