| NPI | 1932426343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02290900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 044041) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-04-23 |