| NPI | 1326462375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 0610610) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 69244) |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2016-04-07 |