| NPI | 1508145533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH NHRPHR2436) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH04950) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2022-07-21 |