| NPI | 1245483585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 000120) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02906300) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2024-02-13 |