| NPI | 1730133042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 041191) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02167400) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2010-02-22 |