| NPI | 1326529512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH234877) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH05351) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2019-10-23 |