| NPI | 1790952596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 14632) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02962000) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2016-05-05 |