| NPI | 1730709221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03966400) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 066639) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2022-07-27 |