| NPI | 1518449172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR46968) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH PHCY-04371) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |