| NPI | 1275371403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.16694) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RJ15163) |
| Enumeration Date | 2024-07-20 |
| Last Update Date | 2024-07-20 |