NPI | 1215291505 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY 057318-I) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NC 22623) |
Enumeration Date | 2012-07-02 |
Last Update Date | 2014-12-15 |