| NPI | 1538753686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH06375) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: MA PI164174) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2022-02-14 |