| NPI | 1326354945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI2962400) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0003489) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2022-03-10 |