| NPI | 1235739434 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 067178) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI04084800) |
| 183500000X Pharmacist (Licence: TX 67639) | |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |