| NPI | 1295447068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 070437) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH87439) |
| Enumeration Date | 2022-12-23 |
| Last Update Date | 2024-07-15 |