| NPI | 1992019657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 17784) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03136700) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2011-05-17 |