| NPI | 1043942527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT 0015933) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 068580) |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2022-06-24 |