| NPI | 1447633862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP446505) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0004312) |
| 183500000X Pharmacist (Licence: NJ 28RI03505300) | |
| 183500000X Pharmacist (Licence: NJ 28RJ04275) | |
| 183500000X Pharmacist (Licence: PA RPI006361) | |
| 183500000X Pharmacist (Licence: NY 059473) | |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2015-07-02 |