| NPI | 1275167561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 3873500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 066489) |
| Enumeration Date | 2020-02-26 |
| Last Update Date | 2020-02-26 |