| NPI | 1467560946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PR 2565) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS52923) |
| 183500000X Pharmacist (Licence: NJ 28RI03323200) | |
| 183500000X Pharmacist (Licence: NY 035733I) | |
| Enumeration Date | 2006-08-26 |
| Last Update Date | 2015-12-04 |