| NPI | 1346522182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 055403-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 011289) |
| 183500000X Pharmacist (Licence: NY 055403) | |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2024-09-24 |