| NPI | 1376772350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: NY 053497) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 053497) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 053497) | |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2015-05-20 |