| NPI | 1073158168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP451629) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI04023300) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2019-11-12 |