| NPI | 1295076800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR12573) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH233995) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2015-05-07 |