| NPI | 1740465194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 048897) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NY 048897) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2013-02-27 |