| NPI | 1144868282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI04043000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 065904) |
| Enumeration Date | 2019-12-19 |
| Last Update Date | 2019-12-19 |