| NPI | 1831377043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI01886400) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP035549R) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2011-10-17 |