| NPI | 1619155843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28ri02860000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 0499881) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-06-09 |