| NPI | 1518411693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03877200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 061962) |
| Enumeration Date | 2016-08-07 |
| Last Update Date | 2023-08-14 |