| NPI | 1164708657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 59000) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: CA 59000) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 59000) | |
| 1835P1300X Pharmacist, Psychiatric (Licence: CA 59000) | |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2011-10-27 |