| NPI | 1407275001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: NJ 28RI03461200) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: FL PS40532) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2014-04-10 |