| NPI | 1023308400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH02099) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH14739) |
| Enumeration Date | 2011-04-19 |
| Last Update Date | 2011-04-19 |