| NPI | 1417265430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH14989) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH02716) |
| Enumeration Date | 2010-09-24 |
| Last Update Date | 2010-09-24 |