| NPI | 1225393127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 67132) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: UT 8328745-1701) |
| Enumeration Date | 2012-07-07 |
| Last Update Date | 2021-11-22 |