| NPI | 1689814394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI0128000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP026014L) |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2009-02-20 |