| NPI | 1649452426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02445700) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 045089-1) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2007-12-03 |