| NPI | 1154639821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 08116) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 08116) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 08116) | |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-16 |