| NPI | 1316247422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps40859) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 20053203) |
| 183500000X Pharmacist (Licence: NJ 3123500) | |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2010-11-10 |