| NPI | 1114274099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: LA 19798) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MS P12646) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2018-12-02 |