| NPI | 1730446881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: NJ 28RI02136400) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NY 029010-1) |
| Enumeration Date | 2012-04-13 |
| Last Update Date | 2012-04-13 |