| NPI | 1417216466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 1765) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0002118) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-11 |