| NPI | 1568712206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 057096) |
| Additional Taxonomies | 1835P1200X Pharmacist Pharmacotherapy (Licence: NY 3151792) |
| 1835X0200X Pharmacist Oncology (Licence: NY 5150832) | |
| 1835G0303X Pharmacist Geriatric (Licence: NY 9103996) | |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2017-12-03 |