| NPI | 1881227155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS52081) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 065125) |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2020-02-17 |