| NPI | 1205013083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02633100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 041413) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2011-01-11 |