| NPI | 1891132361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY i8267904) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri03529400) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2025-12-23 |