| NPI | 1013151737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: VA 0202207563) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP443371) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI03126800) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: DE A1-0003873) | |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2023-09-12 |