NPI | 1518016583 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY 040713) |
Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS29824) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2007-07-08 |