| NPI | 1205013737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 0509331) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri02892000) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |