| NPI | 1881914364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 23889) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 22302) |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2010-11-03 |