| NPI | 1184963506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3907) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR12910) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2014-01-02 |