| NPI | 1982936563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 15814) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02679500) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2018-08-18 |