| NPI | 1649441403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 051651) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 72071) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2015-05-23 |