NPI | 1164704763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY 056168) |
Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP451195) |
Enumeration Date | 2011-09-09 |
Last Update Date | 2017-02-15 |