| NPI | 1972884161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0003199) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202223161) |
| 183500000X Pharmacist (Licence: IL 051308416) | |
| 183500000X Pharmacist (Licence: NJ 28RI02715200) | |
| 183500000X Pharmacist (Licence: NV 24772) | |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2026-08-21 |