| NPI | 1366610289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP447633) |
| 183500000X Pharmacist (Licence: NJ 28RI03573000) | |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2021-02-25 |