| NPI | 1114167384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0011060) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH04760) |
| Enumeration Date | 2009-03-02 |
| Last Update Date | 2019-05-20 |