| NPI | 1104416445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH06137) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH239928) |
| 183500000X Pharmacist (Licence: CT PCT.0015461) | |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-01-20 |