| NPI | 1467644039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ME pr45729) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 051885) |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2022-12-16 |