| NPI | 1134358195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 048984-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS0035611) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2009-07-10 |