| NPI | 1780865006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 044212) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02879000) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2010-03-08 |