| NPI | 1952685190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28ri03151800) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE a10003401) |
| Enumeration Date | 2011-10-06 |
| Last Update Date | 2011-10-06 |