| NPI | 1518281013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 054275) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS29289) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2010-08-18 |