| NPI | 1295813897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 047331) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS42354) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2010-02-18 |