| NPI | 1104320027 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 71790) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 71790) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2022-07-20 |