| NPI | 1609854322 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28R10744700)  | 
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28R10744700)  | 
| Enumeration Date | 2006-01-03 | 
| Last Update Date | 2023-07-26 |