| NPI | 1134342686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP045132R) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01947100) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2022-08-16 |