| NPI | 1033436894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046045-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18943) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2013-01-02 |