| NPI | 1629575568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP451958) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03893100) |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2018-04-08 |