| NPI | 1447477831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02829000) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 15578) |
| 183500000X Pharmacist (Licence: NY 051544) | |
| 183500000X Pharmacist (Licence: PA RP442293) | |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2023-08-16 |