| NPI | 1518240985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202006472) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR3847) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |