| NPI | 1942205836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP437601) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02736900) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2024-03-04 |