| NPI | 1831711662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302413976) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03896500) |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2023-09-19 |