| NPI | 1669794509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02053500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 040468) |
| 183500000X Pharmacist (Licence: PA RP-037954-R) | |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2010-02-19 |