| NPI | 1528498722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 047229) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02639000) |
| 183500000X Pharmacist (Licence: PA RP440002) | |
| 183500000X Pharmacist (Licence: FL PS34652) | |
| Enumeration Date | 2013-11-25 |
| Last Update Date | 2013-11-25 |