| NPI | 1295326080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ RI19217) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL 62062) |
| 183500000X Pharmacist (Licence: WI 19503-40) | |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2021-02-03 |