| NPI | 1194032078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS40883) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 055255) |
| 183500000X Pharmacist (Licence: NJ 28RI03276200) | |
| 183500000X Pharmacist (Licence: MI 5302035863) | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2024-05-17 |