| NPI | 1447563713 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 055141) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri03267800) |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2016-03-16 |