| NPI | 1972039675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH04930) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: RI RPH04930) |
| 1835P2201X Pharmacist Ambulatory Care (Licence: RI RPH04930) | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |