| NPI | 1629294855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3334) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH 04360) |
| 183500000X Pharmacist (Licence: MA 26829) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2016-04-06 |