| NPI | 1962614370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP439768) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02999000) |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2007-07-08 |