| NPI | 1366245151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 20-104318) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 20-104318) |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2025-03-28 |