| NPI | 1326350588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 19135) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03129300) |
| Enumeration Date | 2010-07-04 |
| Last Update Date | 2010-07-04 |