| NPI | 1073781779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP033794L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01968800) |
| Enumeration Date | 2008-02-15 |
| Last Update Date | 2008-02-15 |