| NPI | 1033689195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 066451) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0014183) |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2021-02-10 |