| NPI | 1396923587 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP034716L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28R102076300) |
| 183500000X Pharmacist (Licence: DE A1-0002540) | |
| Enumeration Date | 2008-02-10 |
| Last Update Date | 2008-02-10 |