| NPI | 1861772485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH 3533) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: VT 033.0135746) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2026-06-24 |