| NPI | 1750604914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 050243) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 15969) |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2024-09-04 |