| NPI | 1699097576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 000063) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 15946) |
| 183500000X Pharmacist (Licence: NJ 28RI03037200) | |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2023-03-06 |