| NPI | 1487035218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist Pharmacotherapy (Licence: NY 053324) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: MI 5302035025) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |