| NPI | 1689743049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046123) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NY 046123) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2013-08-09 |