| NPI | 1598027856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS34017) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 040221) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |