| NPI | 1881917813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 038316) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ RI20262) |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2010-03-04 |