| NPI | 1407031917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046079-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02853500) |
| 183500000X Pharmacist (Licence: FL PS33709) | |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2014-02-04 |