| NPI | 1225392962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP439476) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20596) |
| 183500000X Pharmacist (Licence: NY 052265-1) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2024-08-13 |