| NPI | 1467757740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 60762) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR5232) |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2014-12-04 |