| NPI | 1669918256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 092390) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 092390) |
| 183500000X Pharmacist (Licence: FL PSI31092) | |
| 282N00000X General Acute Care Hospital (Licence: NY 092390) | |
| 282N00000X General Acute Care Hospital (Licence: FL PSI31092) | |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |