| NPI | 1982773743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NH 3436) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: MA 26359) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 051716) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: RI RPH6001) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2022-04-11 |