| NPI | 1710285598 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03391500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 055511) |
| 183500000X Pharmacist (Licence: FL PS48289) | |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2016-08-15 |