| NPI | 1861609224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CT 10487) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI03060400) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY I051769-1) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2010-03-05 |