| NPI | 1487977922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302413160) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01724700) |
| Enumeration Date | 2010-03-11 |
| Last Update Date | 2025-01-09 |