| NPI | 1932382983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 000169-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03062200) |
| 183500000X Pharmacist (Licence: MD 16723) | |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2019-11-08 |