| NPI | 1982911921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28ri03068800) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 054118-1) |
| 183500000X Pharmacist (Licence: HI PH-3019) | |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2011-03-11 |