| NPI | 1972347979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835C0205X Pharmacist Critical Care (Licence: NJ 28RI04440700) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP458548) |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-08-07 |