| NPI | 1518249408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NV 16974) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA RPH 59474) |
| 183500000X Pharmacist (Licence: TX 45010) | |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |