| NPI | 1871679266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ RI02425000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS39395) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-11-02 |