| NPI | 1205277621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL PU4827) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS18652) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: AL 9951) | |
| Enumeration Date | 2013-07-14 |
| Last Update Date | 2013-07-14 |