| NPI | 1740662063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA RPH028384) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: ME PR5848) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2015-06-23 |