| NPI | 1689900920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI01643900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP043980R) |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2011-12-25 |