| NPI | 1275848665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR5847) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH232811) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2012-07-17 |