| NPI | 1154713394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 044070) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI02323500) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL PS 45392) | |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2015-02-25 |