| NPI | 1003456963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: KY 018367) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: IN 26028568A) |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |