| NPI | 1023062841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 030625-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 30625) |
| 183500000X Pharmacist (Licence: CA 31276) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2011-07-12 |