| NPI | 1497923379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 036248) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01962500) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2017-03-18 |