| NPI | 1770670572 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NH R1492) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 31565) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-11 |