| NPI | 1366613127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA rph44783) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02142000) |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |