| NPI | 1083993349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: PA RP443606) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: NJ 28RI03789000) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: PA RPI001434) | |
| Enumeration Date | 2011-08-04 |
| Last Update Date | 2017-03-06 |