| NPI | 1376756296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 037680-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH 2085) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2007-07-08 |