| NPI | 1891923355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NJ 28RI02630200) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: FL PH29777) |
| 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: FL PS51153) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2020-07-29 |