| NPI | 1336861152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS49769) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 056498) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2022-09-19 |