| NPI | 1437276623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 21618) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NY 043969) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2012-02-29 |