| NPI | 1760714646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 054287) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03496100) |
| 183500000X Pharmacist (Licence: FL PS46126) | |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2020-09-04 |