| NPI | 1649532532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP439835) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02992600) |
| 183500000X Pharmacist (Licence: DE A1-0003492) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-07-22 |