| NPI | 1649552266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28RI03425000) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NJ 3140460F) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: NJ 6151118) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2025-06-19 |