| NPI | 1437473162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 054301) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: AZ S017402) |
| Enumeration Date | 2010-03-24 |
| Last Update Date | 2015-09-10 |