| NPI | 1023340676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 055496) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP444355) |
| 183500000X Pharmacist (Licence: NJ 28RI03127800) | |
| 183500000X Pharmacist (Licence: NC 20198) | |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2024-06-13 |