| NPI | 1386720084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 48152) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS41445) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2009-12-03 |