| NPI | 1063779510 |
|---|---|
| Former Name | ALEKSANDR KOFMAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046192) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02603600) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2012-04-20 |