| NPI | 1588186787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 061959-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 061959-1) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2018-07-05 |