| NPI | 1548380777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CA 30373) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: CA 30373) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2025-09-11 |