| NPI | 1184256737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 59132) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 59132) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2023-12-26 |