| NPI | 1154951622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: UT 7475454-1701) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: UT 10921906-1703) |
| Enumeration Date | 2020-01-23 |
| Last Update Date | 2023-05-26 |