| NPI | 1942481866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046368) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS35659) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2020-06-11 |