| NPI | 1013231778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 027973) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 01332200) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2010-03-23 |