| NPI | 1437832714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: HI 4976) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 069810-01) |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2023-08-24 |