| NPI | 1043599244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: UT 147130-1701) |
| Enumeration Date | 2011-08-05 |
| Last Update Date | 2011-08-05 |