| NPI | 1346647088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 700081) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OK 14032) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NC 26660) | |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2019-01-14 |