| NPI | 1689952491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03424900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 65384) |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2012-04-11 |