| NPI | 1831453497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP031992L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02105900) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2012-06-28 |