| NPI | 1316071194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03246500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302035067) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2024-01-26 |