| NPI | 1598018376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP446656) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202209965) |
| 183500000X Pharmacist (Licence: NJ 28RI03481600) | |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2012-10-18 |