| NPI | 1447762430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03988100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP451974) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2019-11-14 |