| NPI | 1275810541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 31798) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR5321) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2025-02-19 |