| NPI | 1700227139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 23043) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 032955) |
| Enumeration Date | 2013-07-14 |
| Last Update Date | 2013-07-14 |