| NPI | 1568132884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 068807) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RJ12340) |
| Enumeration Date | 2021-09-17 |
| Last Update Date | 2022-02-01 |