| NPI | 1568115194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 71007) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI04105800) |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2023-05-06 |