| NPI | 1417504341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: NJ 28RI02522500) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS32234) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2020-05-13 |