| NPI | 1003183534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02742600) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: NJ 536088) |
| 183500000X Pharmacist (Licence: NY 056405) | |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2011-11-29 |