| NPI | 1023780707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP445470) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03169300) |
| 183500000X Pharmacist (Licence: DE A1-0004129) | |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2021-10-01 |