| NPI | 1396340931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RPI015785) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI04080300) |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2023-11-24 |