| NPI | 1235476904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 67552) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 67552) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2018-03-15 |