| NPI | 1598211492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 1058933) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03411700) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-08-30 |