| NPI | 1538705256 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: CA RPH78493)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: CA 78493)  | 
| Enumeration Date | 2019-11-19 | 
| Last Update Date | 2022-03-14 |