| NPI | 1407040389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NJ 28RI03191900) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP441822) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2015-12-31 |