| NPI | 1629896048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 072053) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI04367700) |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2024-10-03 |