| NPI | 1225051733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 51263) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA rph57094) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA rph57094) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-02-11 |