| NPI | 1356750368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS21468) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01605200) |
| 183500000X Pharmacist (Licence: PA RP046100R) | |
| 183500000X Pharmacist (Licence: VI 314) | |
| 183500000X Pharmacist (Licence: SC 14007) | |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |