| NPI | 1902183262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NJ 28RI02957500) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MD 16360) |
| 183500000X Pharmacist (Licence: PA RP438929) | |
| 183500000X Pharmacist (Licence: MD 16360) | |
| 183500000X Pharmacist (Licence: NJ 28RI02957500) | |
| 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: PA RP438929) | |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2019-03-19 |