| NPI | 1124752589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI04326900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 31420) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2023-09-06 |