| NPI | 1275082869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202215071) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03813000) |
| Enumeration Date | 2016-09-24 |
| Last Update Date | 2016-09-24 |