| NPI | 1447375969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 041712-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY I041712) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2023-03-21 |