| NPI | 1962950873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP446578) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02694100) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2017-05-11 |