| NPI | 1275056673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH PHCY-04413) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH05725) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2020-11-20 |