| NPI | 1447812128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 065459) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03944800) |
| Enumeration Date | 2019-07-02 |
| Last Update Date | 2023-08-09 |