| NPI | 1083731921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL PS43168) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: PR 002169) |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2016-03-24 |