| NPI | 1588269591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28ri03934800) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp454308) |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-11-30 |