| NPI | 1235590167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH05436) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH233842) |
| Enumeration Date | 2016-03-20 |
| Last Update Date | 2016-03-20 |