| NPI | 1013264159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02096100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 0551761) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2012-08-08 |