| NPI | 1952898579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP451875) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 062928) |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2018-04-19 |