| NPI | 1255610382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0004169) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28rl03438000) |
| Enumeration Date | 2011-08-07 |
| Last Update Date | 2011-08-09 |