| NPI | 1306405402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT pct.0014719) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH02605) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2024-04-18 |