| NPI | 1982994729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA 26607) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02089600) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2011-04-13 |