| NPI | 1861006462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA ph234915) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI rph05275) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |