| NPI | 1326270653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: NY 20049079) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 20049079) |
| 1835G0303X Pharmacist Geriatric (Licence: NY 20049079) | |
| 1835N1003X Pharmacist Nutrition Support (Licence: NY 20049079) | |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 20049079) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |