| NPI | 1881855856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 34265) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 034265) |
| Enumeration Date | 2008-06-22 |
| Last Update Date | 2026-02-19 |