| NPI | 1205400280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: RI Rph04009) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: RI Rph04009) |
| Enumeration Date | 2021-05-14 |
| Last Update Date | 2021-05-14 |