NPI | 1215259544 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH23202) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NY 052149-1) |
183500000X Pharmacist (Licence: NH 3076) | |
Enumeration Date | 2010-03-01 |
Last Update Date | 2023-01-26 |