| NPI | 1275913485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 048567) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02763400) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-06-02 |