| NPI | 1841674801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 060548) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NH R3133) |
| 183500000X Pharmacist (Licence: NY 060548) | |
| 183500000X Pharmacist (Licence: VT 0330117935) | |
| 183500000X Pharmacist (Licence: MA PH237023) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: VT 0330117935) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: VT 0330117935) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: VT 0330117935) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: VT 0330117935) | |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2022-04-28 |