| NPI | 1366446387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI01902600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 037355-1) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2007-07-08 |