| NPI | 1588845218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 34637) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01709100) |
| Enumeration Date | 2007-11-22 |
| Last Update Date | 2008-02-20 |