| NPI | 1427378611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 042811) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 59521) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2023-02-06 |