| NPI | 1417998469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 040471) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 040471) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-08-01 |