| NPI | 1992029755 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 043538) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL ps30894) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2010-03-23 |