| NPI | 1962796235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI rph04901) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 0010763) |
| Enumeration Date | 2011-06-04 |
| Last Update Date | 2011-06-04 |