| NPI | 1184618092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: RI RPH04245) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH04245) |
| 183500000X Pharmacist (Licence: MA 025236) | |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2025-04-07 |