| NPI | 1851553507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 052328) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03008600) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2022-03-31 |