| NPI | 1073835088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 051595) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ NJ28RI03034700) |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2013-07-27 |