| NPI | 1639459506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 054500-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 054500-1) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2012-06-14 |