| NPI | 1700277175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: RI RPH05636) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP449025) |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2016-10-03 |