| NPI | 1023342490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 051560-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02991100) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2024-05-28 |