| NPI | 1114294725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY I056443) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 056443) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2019-08-06 |