| NPI | 1356869309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH PHCY-04344) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0131286) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2022-06-30 |