| NPI | 1013924844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NV 15742) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: NV 6110271) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2015-05-08 |