| NPI | 1477967305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 17523) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 37865) |
| 183500000X Pharmacist (Licence: FL ps47307) | |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |