| NPI | 1841331725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 042879-1) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 042879-1) |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: NY 20042879) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-10-31 |