| NPI | 1811182215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI02293300) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP034080L) |
| 183500000X Pharmacist (Licence: DE A1-0003023) | |
| Enumeration Date | 2007-09-09 |
| Last Update Date | 2007-09-09 |