| NPI | 1366677387 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28ri02656100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 045009) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2021-05-25 |