NPI | 1871004135 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NY 063862) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03900100) |
Enumeration Date | 2017-10-13 |
Last Update Date | 2018-02-14 |