| NPI | 1689122038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: NY I061133) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: FL PS53948) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2022-07-21 |