| NPI | 1407009806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 052856) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 052856-1) |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2019-12-02 |