| NPI | 1174710883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH04363) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 9306) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2025-08-13 |