| NPI | 1427227065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 042612-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28r102264000) |
| 183500000X Pharmacist (Licence: CA rph43558) | |
| 183500000X Pharmacist (Licence: CO 11587) | |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |