| NPI | 1750643466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH05008) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0011972) |
| Enumeration Date | 2012-06-10 |
| Last Update Date | 2012-06-10 |