| NPI | 1154763928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR12975) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 3884) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2020-11-25 |