| NPI | 1548492648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03158900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 5703099) |
| Enumeration Date | 2009-08-23 |
| Last Update Date | 2009-08-23 |