| NPI | 1427434786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03681000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 060508-1) |
| Enumeration Date | 2015-08-09 |
| Last Update Date | 2015-08-10 |