| NPI | 1699104125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3951) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR13011) |
| 183500000X Pharmacist (Licence: CT PCT.0012738) | |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2014-11-05 |