| NPI | 1992118236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004148) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp444150) |
| 183500000X Pharmacist (Licence: NJ 28RI03322800) | |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2025-09-30 |