| NPI | 1497168553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004233) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28Rl03624400) |
| 183500000X Pharmacist (Licence: MD 22230) | |
| 183500000X Pharmacist (Licence: NY 20058798) | |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2022-01-07 |