| NPI | 1689212573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 124668) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR69587) |
| Enumeration Date | 2019-12-11 |
| Last Update Date | 2020-10-15 |