| NPI | 1013218742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 035020) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 035020) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2010-11-11 |