| NPI | 1235456641 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CT PCT.0006482)  | 
| Enumeration Date | 2010-04-24 | 
| Last Update Date | 2019-06-03 |