| NPI | 1962627505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP044620R) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01510400) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-07-08 |