| NPI | 1457537359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 033389) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01927200) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2015-12-21 |