| NPI | 1558182766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI04254800) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 3170595) |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2024-10-21 |