| NPI | 1083946115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 047288) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02788500) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2023-12-29 |