| NPI | 1871742833 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 049256) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03046300) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2013-07-01 |