| NPI | 1033735725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY I066777) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03985600) |
| Enumeration Date | 2020-06-18 |
| Last Update Date | 2020-11-17 |