| NPI | 1487977245 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 060215) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP443902) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2024-02-16 |