| NPI | 1467588616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 050792) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03042000) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2007-07-08 |