| NPI | 1417280652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT0009700) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02804900) |
| 183500000X Pharmacist (Licence: IL 051292532) | |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2015-12-26 |