| NPI | 1962083915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH235205) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH05360) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-04-20 |