| NPI | 1609325927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP364458) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 061660-1) |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2020-11-30 |