| NPI | 1831423201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR6065) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ME LC12200) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2013-07-17 |