| NPI | 1053125914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 89607) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 11583) |
| 183500000X Pharmacist (Licence: MN 123728) | |
| Enumeration Date | 2025-02-03 |
| Last Update Date | 2025-09-24 |