| NPI | 1841474392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 051137) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03440562) |
| 183500000X Pharmacist (Licence: PA RP456072) | |
| 183500000X Pharmacist (Licence: MD 27890) | |
| Enumeration Date | 2007-12-19 |
| Last Update Date | 2024-02-19 |