| NPI | 1831411578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY I037466) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS 22902) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2012-10-24 |