| NPI | 1831422948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH02104) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA 15839) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2009-09-09 |