| NPI | 1043050537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT0016559) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH1000261) |
| 183500000X Pharmacist (Licence: RI RPH06595) | |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2025-02-10 |