| NPI | 1780937474 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH04916) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 15167) |
| 183500000X Pharmacist (Licence: MA PH233455) | |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2016-05-31 |