| NPI | 1275135840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH06169) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP454723) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2022-03-29 |