| NPI | 1982928958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 0521711) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: PA RP441285) |
| Enumeration Date | 2010-03-19 |
| Last Update Date | 2015-09-23 |