| NPI | 1740443266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 28370) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 0369841) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2024-02-12 |