| NPI | 1578842621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 055694-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03394200) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2011-08-08 |