| NPI | 1225412745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP449710) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03735100) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-11-11 |