| NPI | 1902328065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: NJ 28RI03619900) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: CO PHA.0020184) |
| 1835G0303X Pharmacist, Geriatric (Licence: DE A1-0004441) | |
| 1835G0303X Pharmacist, Geriatric (Licence: MD 21867) | |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2017-07-11 |