| NPI | 1447077144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI04379000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 33186) |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |