| NPI | 1659888204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NJ 28RI03891200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NJ 28RI03891200) |
| Enumeration Date | 2018-01-04 |
| Last Update Date | 2021-01-04 |