| NPI | 1346412475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS64186) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 048172) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2023-01-02 |