| NPI | 1912185125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP027164L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01237300) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2016-11-09 |