| NPI | 1326366634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 050561) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 0010935) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-05-11 |