| NPI | 1346755824 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 83757) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 063590) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2024-09-24 |