| NPI | 1255574950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302027977) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01836400) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2022-04-30 |