| NPI | 1548517071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH233723) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH05044) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2012-08-15 |