| NPI | 1013127588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NV 14000) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: CA 46195) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 46195) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2025-09-11 |