| NPI | 1487978714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 041687) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 041687) |
| Enumeration Date | 2010-03-15 |
| Last Update Date | 2012-09-11 |