| NPI | 1851630388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP447284) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03539100) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-12-09 |