| NPI | 1992986095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046122) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 24968) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2018-08-27 |