| NPI | 1619311289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 054332) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI03327800) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2013-04-25 |