| NPI | 1629479837 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: OR RPH-0014304)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0014304)  | 
| Enumeration Date | 2014-09-07 | 
| Last Update Date | 2015-12-18 |