| NPI | 1508340589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202211987) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02207200) |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2018-09-17 |