| NPI | 1902427875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0003373) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02372200) |
| 183500000X Pharmacist (Licence: PA RP040668L) | |
| 183500000X Pharmacist (Licence: MD 25464) | |
| Enumeration Date | 2020-05-02 |
| Last Update Date | 2020-05-02 |