| NPI | 1477876951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 051869-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP442104) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2010-03-11 |