| NPI | 1184933319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03074100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 050754) |
| 183500000X Pharmacist (Licence: DE a10002833) | |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2010-11-13 |