| NPI | 1285257022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AK PH811) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 174H00000X Health Educator | |
| 1835N1003X Pharmacist, Nutrition Support (Licence: AK PH811) | |
| 207PH0002X Emergency Medicine, Hospice and Palliative Medicine (Licence: AK PH811) | |
| 208U00000X Clinical Pharmacology (Licence: AK PH811) | |
| 251E00000X Home Health | |
| 251F00000X Home Infusion | |
| 251G00000X Hospice Care, Community Based | |
| 302F00000X Exclusive Provider Organization | |
| 305S00000X Point of Service | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-05-27 |