| NPI | 1457763450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 050746) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 050746) |
| 1835P1300X Pharmacist, Psychiatric (Licence: NY 050746) | |
| Enumeration Date | 2014-05-24 |
| Last Update Date | 2021-05-04 |