| NPI | 1821386194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0011089) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 055570) |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2022-12-19 |