| NPI | 1063964682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR ORRPH0013344) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2019-10-29 |