| NPI | 1184950164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 18944) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03303700) |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2009-11-09 |