| NPI | 1851429955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 050737) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03003500) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2021-01-11 |