| NPI | 1801930359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT 10363) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH04502) |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2009-07-07 |