| NPI | 1881917706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03415400) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 046894) |
| Enumeration Date | 2010-03-05 |
| Last Update Date | 2011-03-31 |