| NPI | 1407218027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME pr5062) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH25249) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |