| NPI | 1437424892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY I055699) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 0011125) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |