| NPI | 1548577083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 52203) |
| Additional Taxonomies | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: TX 52203) |
| 1835P2201X Pharmacist, Ambulatory Care (Licence: TX 52203) | |
| Enumeration Date | 2010-09-03 |
| Last Update Date | 2022-12-07 |