| NPI | 1699088476 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP441049) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03115500) |
| 183500000X Pharmacist (Licence: MD 17357) | |
| 183500000X Pharmacist (Licence: FL PS38632) | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2010-07-21 |