| NPI | 1467040915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: CA 82382) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 82382) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 82382) | |
| Enumeration Date | 2021-01-08 |
| Last Update Date | 2022-05-17 |