| NPI | 1184906653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202204188) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02155000) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2012-03-02 |