| NPI | 1841772241 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 064606) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI04437600) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2026-08-18 |