| NPI | 1801110374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 20053382) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ RI03021900) |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2010-03-26 |