| NPI | 1508267261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT 0007458) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 28RI02232100) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |