| NPI | 1952657637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP446522) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02610700) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2022-05-31 |