| NPI | 1992037246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 1055619) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03326100) |
| Enumeration Date | 2010-02-10 |
| Last Update Date | 2015-09-16 |