| NPI | 1992227201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835G0303X Pharmacist, Geriatric (Licence: NJ 28RI03577600) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: PA RP450451) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2017-07-10 |