| NPI | 1245247659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NJ 28RI02904300) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: AZ s013377) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: AZ S013377) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 28RI02904300) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2011-06-15 |