| NPI | 1063618429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI02831200) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 0000029777) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CT 9832) | |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2008-01-17 |