| NPI | 1477875516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP039281L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: DE A1-0002490) |
| 183500000X Pharmacist (Licence: NJ 28RI02704600) | |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2016-03-11 |