| NPI | 1205152683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 054451) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03187800) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 054451) | |
| Enumeration Date | 2010-04-11 |
| Last Update Date | 2010-11-09 |