| NPI | 1538575071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: NM PC00000282) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00007426) |
| Enumeration Date | 2014-07-04 |
| Last Update Date | 2017-10-26 |