| NPI | 1417541574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI04201500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA PI121714) |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-09-09 |