| NPI | 1588091078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 058775) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03483000) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2014-02-10 |