| NPI | 1306093737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 047061) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02588000) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2012-09-27 |