| NPI | 1801082607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03159600) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 18867) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2025-03-27 |