| NPI | 1043530884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28R103283200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp444103) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2010-06-03 |