| NPI | 1598153678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY I059983-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RJ05801) |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2014-12-24 |