| NPI | 1295054989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: AL 12269) |
| Additional Taxonomies | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: AL 12269) |
| 183500000X Pharmacist (Licence: GA RPH018207) | |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2013-04-30 |