| NPI | 1942025135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03553200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 068819) |
| Enumeration Date | 2024-11-21 |
| Last Update Date | 2024-11-21 |