| NPI | 1023589900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY I063933) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IN 26026824A) |
| 183500000X Pharmacist (Licence: MO 2015027216) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2018-12-17 |