| NPI | 1457508889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 052390-1) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 004064-1) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2025-08-19 |