| NPI | 1801416813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: ID 3181304) |
| Additional Taxonomies | 1835C0205X Pharmacist, Critical Care (Licence: ID 1181304) |
| 1835I0206X Pharmacist, Infectious Diseases (Licence: FL PS69934) | |
| 202C00000X Independent Medical Examiner (Licence: ID 3181304) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: NJ 28RI04058400) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: ID 3181304) | |
| 171000000X Military Health Care Provider (Licence: ID 1181304) | |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2026-04-02 |