| NPI | 1376911412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R2733) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 056761) |
| Enumeration Date | 2015-09-07 |
| Last Update Date | 2022-09-08 |