| NPI | 1477843282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: UT 145651-1701) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CO 11551) |
| 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NE 10573) | |
| 207Q00000X Family Medicine (Licence: NE 16677) | |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2018-04-26 |