| NPI | 1700118908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA rp443487) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 2785) |
| 183500000X Pharmacist (Licence: MA 21889) | |
| 183500000X Pharmacist (Licence: ME pr5264) | |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2010-02-12 |