| NPI | 1477137008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR4379) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH R2720) |
| 183500000X Pharmacist (Licence: MA PH237272) | |
| 183500000X Pharmacist (Licence: CT PCT.0014665) | |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2021-05-10 |