| NPI | 1306816749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: PA RP034620L) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA RP034620L) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2026-06-24 |