| NPI | 1043468622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046596-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ RI-25005) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2008-09-08 |