| NPI | 1699262998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NE 14693) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR27919) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |