| NPI | 1467508192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS54730) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 30414) |
| 183500000X Pharmacist (Licence: NJ 28RI02926400) | |
| 183500000X Pharmacist (Licence: MD 16804) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-06-29 |