| NPI | 1487801973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY I050875) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 050875) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2025-06-13 |