| NPI | 1134195571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NM PHC - 000018) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP - 039745-L) |
| 183500000X Pharmacist (Licence: NM RP - 00005624) | |
| Enumeration Date | 2006-02-26 |
| Last Update Date | 2008-04-14 |