| NPI | 1346500162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03455400) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP446013) |
| Enumeration Date | 2012-05-26 |
| Last Update Date | 2012-05-26 |