| NPI | 1023447810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03563700) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 22776) |
| 183500000X Pharmacist (Licence: PA RP448243) | |
| 183500000X Pharmacist (Licence: MA PH234719) | |
| 183500000X Pharmacist (Licence: CA 69442) | |
| 183500000X Pharmacist (Licence: TX 53845) | |
| 183500000X Pharmacist (Licence: VA 0202213483) | |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2014-09-28 |