| NPI | 1093090763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TN 40967) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: KY 014570) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: TN 40967) | |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: TN 40967) | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2023-06-29 |