| NPI | 1144747197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH238594) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR46787) |
| Enumeration Date | 2017-08-29 |
| Last Update Date | 2019-02-22 |