| NPI | 1659688307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 63940) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03335100) |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-01 |