| NPI | 1386610855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA 30586) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 30586) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NV 06648) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2011-01-24 |