| NPI | 1659755403 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI03079400) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NJ 28RI03079400) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2015-07-10 |