| NPI | 1710574694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PHP232600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH05435) |
| 183500000X Pharmacist (Licence: CT PCT.0013260) | |
| 183500000X Pharmacist (Licence: HI PH-3989) | |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2020-12-28 |