| NPI | 1518489632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03376100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NE 15220) |
| 183500000X Pharmacist (Licence: PA RP450485) | |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2017-07-11 |