NPI | 1134590656 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03777700) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NY 061773) |
Enumeration Date | 2015-10-09 |
Last Update Date | 2021-11-03 |