| NPI | 1649873423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 1053287) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02045400) |
| Enumeration Date | 2020-11-16 |
| Last Update Date | 2020-11-16 |