| NPI | 1528390465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 035892-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202005220) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |