NPI | 1205469863 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03295400) |
Additional Taxonomies | 183500000X Pharmacist (Licence: WI 15761-40) |
Enumeration Date | 2020-02-21 |
Last Update Date | 2022-06-04 |