| NPI | 1295086809 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: MA 27052) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NH R2346) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2012-09-21 |