| NPI | 1154618148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 040619) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OH 03-2-26533) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2014-07-16 |