| NPI | 1588662977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT 6287) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 039073) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2007-07-08 |