| NPI | 1013394840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28ri03369300) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 057412) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2015-04-30 |