| NPI | 1528376936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 054082) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03325500) |
| Enumeration Date | 2010-09-20 |
| Last Update Date | 2016-11-10 |