| NPI | 1326421868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 34916) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS39921) |
| 183500000X Pharmacist (Licence: NJ 28RI01633200) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |