| NPI | 1205683414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 069508) |
| Additional Taxonomies | 1835N0905X Pharmacist, Nuclear (Licence: NY 069508) |
| Enumeration Date | 2024-05-04 |
| Last Update Date | 2025-01-11 |