| NPI | 1285956599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 053521) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS49622) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2022-12-12 |