| NPI | 1992898530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME PR0002929) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH RR1155) |
| 183500000X Pharmacist (Licence: MA 15540) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |