| NPI | 1427846633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI04444100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 073501) |
| 183500000X Pharmacist (Licence: PA RP459664) | |
| Enumeration Date | 2025-04-28 |
| Last Update Date | 2026-06-21 |