| NPI | 1477204477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0015272) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 068277) |
| Enumeration Date | 2022-01-12 |
| Last Update Date | 2023-01-13 |