| NPI | 1326401209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP445504) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03363300) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |