| NPI | 1013261163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR3938) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH R1115) |
| Enumeration Date | 2012-10-27 |
| Last Update Date | 2012-10-27 |