| NPI | 1366719692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CO 19364) |
| Additional Taxonomies | 1835P1300X Pharmacist Psychiatric (Licence: CO 19364) |
| 183500000X Pharmacist (Licence: CO 19364) | |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2019-05-10 |