| NPI | 1992949994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS46180) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri02685000) |
| 183500000X Pharmacist (Licence: MA ph22157) | |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2023-03-21 |