| NPI | 1073642690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02985500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 042648) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2010-02-18 |