| NPI | 1588903637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RP034298L) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: PA RPI003102) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI01859100) | |
| Enumeration Date | 2013-02-10 |
| Last Update Date | 2013-02-10 |