| NPI | 1649552266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NJ 3140460F) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03425000) |
| 183500000X Pharmacist (Licence: PA RP445995) | |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NJ 3140460F) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: NJ 6151118) | |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2018-11-09 |