| NPI | 1023613866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: RI RPH05499) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH05499) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2025-05-06 |