| NPI | 1477545259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 051657) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OH 03125870) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2010-04-02 |