| NPI | 1881965069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 053549-1) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 0000023991) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: IN 051.291254) | |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2012-01-20 |