| NPI | 1770814881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 032112-1) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 032112) |
| 1835P1200X Pharmacist Pharmacotherapy (Licence: NY 032112) | |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-01-29 |