| NPI | 1770752354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 025199) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 23523) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |