| NPI | 1144272774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 047013-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 047013-1) |
| 183500000X Pharmacist (Licence: FL PS 34375) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2012-03-13 |