| NPI | 1851929194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP030330L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01725200) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2020-03-31 |