| NPI | 1235568460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02847300) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202204479) |
| 183500000X Pharmacist (Licence: PA RP045810R) | |
| 183500000X Pharmacist (Licence: DE A1-0004414) | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2013-11-07 |