| NPI | 1942634639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP447713) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03619700) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2016-05-07 |