| NPI | 1689953101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 056005) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY i056005) |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2024-05-22 |