| NPI | 1831479492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03370600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IL 051.295177) |
| 183500000X Pharmacist (Licence: MD 20867) | |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2012-09-16 |