| NPI | 1508468356 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH05933) | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT0014574) | 
| Enumeration Date | 2020-11-16 | 
| Last Update Date | 2020-12-20 |