| NPI | 1871184960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03358200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP451363) |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2023-02-13 |