| NPI | 1407024318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02219100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP-039392-L) |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-02-13 |