| NPI | 1548605520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA ph27443) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH06094) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2020-07-06 |