| NPI | 1386999688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS49125) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: FL PU10513) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: FL PS49125) | |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2026-06-25 |