| NPI | 1043532849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 047476) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 028ri27183) |
| Enumeration Date | 2010-02-20 |
| Last Update Date | 2010-02-20 |