| NPI | 1639484157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 055676-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03234300) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2018-04-23 |