| NPI | 1427001858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 041587) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps27471) |
| 183500000X Pharmacist (Licence: NH 2769) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-07-08 |