| NPI | 1669794046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02542200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 040712) |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2010-03-07 |