| NPI | 1497237531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 065227) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03967100) |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2023-03-03 |