| NPI | 1265671804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1300X Pharmacist Psychiatric (Licence: NY 031491) |
| Additional Taxonomies | 1835G0303X Pharmacist Geriatric (Licence: NY 031491) |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 031491) | |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: NY 031491) | |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2015-01-10 |