| NPI | 1023321957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS23397) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 20925) |
| 183500000X Pharmacist (Licence: NJ 28RI01961800) | |
| 183500000X Pharmacist (Licence: MA PH21871) | |
| 183500000X Pharmacist (Licence: MD 17399) | |
| 183500000X Pharmacist (Licence: NY 036695-1) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2010-07-20 |