| NPI | 1750606422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 039000-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP036045L) |
| 183500000X Pharmacist (Licence: FL PS25198) | |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2013-05-30 |