| NPI | 1427676329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NC 700559) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 31918) |
| 183500000X Pharmacist (Licence: VA 0202218801) | |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2025-12-31 |