| NPI | 1053922195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TN 0000042121) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-13 |