| NPI | 1720081284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046168) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri02603700) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2007-07-08 |