| NPI | 1265709265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NY 040973-1) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 040973-1) |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2024-04-17 |