| NPI | 1225454150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 68813) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 059006) |
| 183500000X Pharmacist (Licence: NJ 28RI03530200) | |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2022-01-22 |