| NPI | 1184055758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03507900) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MD 20996) |
| 183500000X Pharmacist (Licence: PA RP447188) | |
| 183500000X Pharmacist (Licence: DE A1-0004318) | |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |