| NPI | 1275706798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 050505-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02896100) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2010-03-12 |