| NPI | 1962176735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI04110600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RJ08766) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2021-08-05 |