| NPI | 1447578133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP441400) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03254700) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2021-11-10 |