| NPI | 1215783493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 071164) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI04351700) |
| Enumeration Date | 2024-04-27 |
| Last Update Date | 2024-04-30 |