| NPI | 1548682354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MN 121432) |
| Additional Taxonomies | 3336I0012X Pharmacy, Institutional Pharmacy |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2018-11-28 |