NPI | 1508148040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY 055589) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03298500) |
Enumeration Date | 2011-09-11 |
Last Update Date | 2011-09-11 |