| NPI | 1740708924 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS57065) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03970600) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2022-12-18 |