| NPI | 1578843439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: DE A1-0002337) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI01797700) |
| 183500000X Pharmacist (Licence: PA RP445206) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |