| NPI | 1720260318 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: IL 051.288749) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02932800) |
| 183500000X Pharmacist (Licence: PA RP439225) | |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2007-12-05 |