| NPI | 1992164008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 65452) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03359500) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |