NPI | 1164706743 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NC 21697) |
Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01994500) |
183500000X Pharmacist (Licence: PA RP030296L) | |
183500000X Pharmacist (Licence: NJ 28RJ03098) | |
Enumeration Date | 2011-09-30 |
Last Update Date | 2021-02-24 |