| NPI | 1336424860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH04202) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH25947) |
| 183500000X Pharmacist (Licence: CT PCT.0009455) | |
| Enumeration Date | 2011-10-16 |
| Last Update Date | 2011-10-16 |