An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Pharmacist | 183500000X |
| General Practice | 208D00000X | |
| Occupational Medicine | 2083X0100X | |
| Sports Medicine | 2083S0010X |
* Indicates primary specialty
| NPI Number | 1033256805 |
| Credentials | MD |
| Entity | Individual |
| Enumeration date | 01/31/2007 |
| Last updated | 09/11/2025 - About 9 months ago |
| Sole proprietor1 | No |
| Identifiers |
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| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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