| NPI | 1841570397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH03708) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH22513) |
| 183500000X Pharmacist (Licence: FL PS31909) | |
| Enumeration Date | 2011-08-27 |
| Last Update Date | 2011-08-27 |