| NPI | 1700133766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02986900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 20055536) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2012-08-09 |