| NPI | 1447552781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TN 36106) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 054848) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2020-04-13 |