| NPI | 1114388576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02278000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RJ01688) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2016-03-14 |