| NPI | 1497642698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: RI RPH05900) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: FL PS60125) |
| Enumeration Date | 2025-06-20 |
| Last Update Date | 2025-06-20 |