| NPI | 1982058376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: CT 0013519) |
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: NJ 28RI03732200) |
| 2278P3900X Respiratory Therapist, Certified, Neonatal/Pediatrics (Licence: NY 007308) | |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2016-08-10 |