| NPI | 1760094288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY O68967-01) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 82874) |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2023-03-28 |