| NPI | 1568429439 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 046211) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 046211) |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2022-07-27 |