| NPI | 1194167791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NM PC00000334) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP8027) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2023-08-31 |