| NPI | 1255953055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MD 27192) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0004417) |
| 183500000X Pharmacist (Licence: NJ 28RI03552500) | |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2020-05-14 |