| NPI | 1346782315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: PA RP450009) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: NJ 28RI03866900) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2022-12-02 |