| NPI | 1447805791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 065484) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri03996900) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2019-08-05 |