| NPI | 1366764672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA rp442804) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 052808) |
| Enumeration Date | 2010-02-28 |
| Last Update Date | 2010-02-28 |