| NPI | 1881963445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: IA 24318) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 037627) |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2023-04-21 |