| NPI | 1780382853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0016216) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 068941) |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2025-02-18 |