| NPI | 1831499821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AZ S019866) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY I054684) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2013-08-13 |