| NPI | 1407246317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI02068700) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: DE A1-0002405) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: VA 0202207746) | |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |