| NPI | 1689092983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MN 121129) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 121129) |
| 183500000X Pharmacist (Licence: ND 5482) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2019-10-04 |