| NPI | 1306446950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS65604) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 067168) |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2023-08-30 |