| NPI | 1437394392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 047539) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 36047) |
| Enumeration Date | 2008-12-06 |
| Last Update Date | 2021-01-17 |