| NPI | 1023611894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP452779) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH234146) |
| 183500000X Pharmacist (Licence: NJ 28RI03941600) | |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2020-11-16 |