| NPI | 1811201627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 054280-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01275200) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2010-08-04 |