| NPI | 1548544208 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202206384) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03333000) |
| 183500000X Pharmacist (Licence: PA RP444390) | |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |