| NPI | 1336289370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: GA RPH019039) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: GA RPH019039) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2026-03-05 |