| NPI | 1346554615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 054801) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 07544) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2026-06-18 |