| NPI | 1083254304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: UT 317179-1701) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2020-01-14 |