| NPI | 1215342209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MA PH240122) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT PCT.0012736) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2023-02-27 |