| NPI | 1528398468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 051809-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 051809) |
| Enumeration Date | 2009-12-27 |
| Last Update Date | 2019-06-19 |