| NPI | 1568246700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA rp440419) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri04295000) |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |