| NPI | 1609205723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR12956) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME 12956) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2013-11-08 |