| NPI | 1760653711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 031282) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: NY 031282) |
| Enumeration Date | 2008-03-18 |
| Last Update Date | 2008-03-18 |