| NPI | 1396117727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: NJ 28R103087100) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: PA RP440128) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |