| NPI | 1881906154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA rp038421l) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28ri03095300) |
| 183500000X Pharmacist (Licence: FL ps30803) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2010-07-02 |