| NPI | 1568174472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS27582) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01781500) |
| 183500000X Pharmacist (Licence: PA RP446424) | |
| Enumeration Date | 2022-12-22 |
| Last Update Date | 2022-12-22 |