| NPI | 1154572642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02935300) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 050468) |
| 183500000X Pharmacist (Licence: CT PCT.0010967) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2008-10-02 |