| NPI | 1205969425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R2057) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME pr5330) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2011-01-20 |