| NPI | 1538451380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 65217) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri03399200) |
| Enumeration Date | 2011-05-12 |
| Last Update Date | 2013-10-11 |