| NPI | 1477906568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03638800) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP450438) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |