| NPI | 1164967964 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: NY 056295) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 056295) |
| Enumeration Date | 2017-01-03 |
| Last Update Date | 2017-01-03 |