| NPI | 1689784407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NM RP00007465) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28r102012900) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2025-08-14 |