| NPI | 1871817759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: NY 034155) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 034155) |
| Enumeration Date | 2010-03-21 |
| Last Update Date | 2010-03-21 |