| NPI | 1396177101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS50776) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 068717) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2023-08-23 |