| NPI | 1184966269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28rj04482) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri03533700) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2013-03-26 |