| NPI | 1174787048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS43653) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL CDE - 20120578) |
| 183500000X Pharmacist (Licence: FL CACP - 0773-olc-0513) | |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL BCACP - 6110343) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2014-08-06 |